Individual
MR. RICHARD STAT ROTH
Active
Individual
MR. RICHARD STAT ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036446
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532441E
—
GA
01
—
440003516
RR MEDICARE
GA
01
—
454524
BCBS
GA
05
—
G36446
—
SC
Enumeration date
07/15/2005
Last updated
02/28/2023
Update your record
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